The Stem Cell Transplant Center at Dana-Farber/Boston Children’s performs autologous and allogeneic stem cell transplants (also called bone marrow transplants) to treat and support the treatment of pediatric cancers, blood disorders, and other conditions. We are among the biggest and most experienced pediatric stem cell transplant programs in the world, performing more than 100 transplants annually. Our group includes physicians and researchers who are leaders in pediatric stem cell hair transplant, along with nationally understood pediatric subspecialists. Our advanced stem cell transplant facility is created specifically for children and teenagers going through stem cell transplant– reducing their direct exposure to harmful toxic substances and germs without preventing their flexibility to leave their room or engage with family and friends.
Stem cell transplantation (also called a bone marrow transplant) is a therapy for children with cancer or other illness that affect their bone marrow. Bone marrow is a specialized tissue inside the bones that produces all the body’s blood cells. The goal of a stem cell transplant is to transfuse healthy bone marrow cells into your child after unhealthy bone marrow has actually been destroyed.
Pediatric Stem Cell Transplant
Emphasizes of our Stem Cell Transplant Center consist of:
- A 14-bed transplant unit specifically developed for the needs of children going through a stem cell transplant
- An active, world-renown research program with researchers who partner with our scientific team to enhance outcomes for hematopoietic stem cell transplants
- Among the only graft-versus-host disease (GVHD) centers in the country for pediatric stem cell transplant patients, using specialized care for children and teenagers affected with this condition
- The only pediatric center in New England to receive the Cigna LifeSOURCE Transplant Network Center of
- Excellence status for Bone Marrow Transplant
- Called a Center of Medical Quality by the Bone Marrow Transplant Quality Review Committee at UniCare. We received this distinction based upon our Structure for the Accreditation of Cellular Therapy (REALITY) accreditation, our quality of care, high patient volume, and high number of results over an extended amount of time.
Stem cells are cells in the body that have the possible to develop into anything, such as a skin cell, a liver cell, a brain cell, or a blood cell. Stem cells that become blood cells are called hematopoietic (heh-mat-uh-poy-EH-tik) stem cells. These cells are capable of becoming the 3 types of blood cells:
- red blood cells that carry oxygen
- leukocyte that battle infection
- platelets that help blood to clot
Hematopoietic stem cells can be discovered in bone marrow (the spongy tissue inside bones), the blood stream, and the umbilical cord blood of newborn babies.
A stem cell transplant (sometimes called a bone marrow transplant) can renew a child’s supply of healthy hematopoietic stem cells after they have actually been depleted. It’s used to treat a large range of illness, including cancers like leukemia, lymphoma, neuroblastoma, Wilms growth, and certain testicular or ovarian cancers; blood conditions; body immune system diseases; and bone marrow syndromes.
Transplanted hematopoietic stem cells are taken into the bloodstream through an intravenous (IV) line, much like a blood transfusion. When in the body, they can produce healthy new blood and body immune system cells.
Types of Transplants
The two primary types of stem cell transplants are autologous (aw-TAHL-uh-gus) and allogeneic (al-uh-juh-NEE-ik). The kind of transplant required will depend on the child’s particular medical condition and the availability of a coordinating donor.
- Autologous hematopoietic stem cell transplant. With this kind of transplant, patients serve as their own donor. For example, a child who will undergo cancer treatment will have his/her own stem cells gotten rid of (collected) and frozen for later use. After the child receives chemotherapy and/or radiation, the stem cells are thawed and returned into the child’s body.
This procedure may be done when or lot of times, depending on the need. Sometimes physicians will use extra-high doses of chemotherapy during treatment (to kill as lots of cancer cells as possible) if they understand a patient will be getting a stem cell transplant right after.
- Allogeneic hematopoietic stem cell transplant. With an allogeneic transplant, the stem cells come from a donor– frequently a sibling however often another volunteer– whose cells are considered a “match” for the patient. The process of discovering a match is called tissue typing (or HLA [human leukocyte antigen] typing). HLA is a protein on the surface of blood cells. Generally, the more “HLA markers” a child and the prospective donor have in common, the higher the chance that the transplant will achieve success.
Unlike with an autologous transplant, there is a risk of a child’s body turning down the contributed cells. This means that the body’s own immune cells ruin the transplanted stem cells due to the fact that they notice they are foreign. Often, in spite of the donor being a good match, the transplant simply might not take. Other times, the donor cells can begin to make immune cells that attack the recipient’s body. This condition is called graft-versus-host disease, and can be rather major. Luckily, most cases are successfully treated with steroids and other medications.
In some cases, a benefit of graft-versus-host disease is that the freshly transplanted cells recognize the body’s cancer cells as different or foreign, and actually work to eliminate them.
Stem cell hair transplant is a very complicated procedure that may span a number of months. A team of physicians is usually involved in determining if a child is a prospect and, if so, whether the transplant will be autologous or allogeneic.
For an allogeneic transplant, a suitable donor will be sought among relative or through a national registry of volunteers. Once a match is found, the donor’s stem cells will be harvested. Three various types of hematopoietic stem cells can be gathered or harvested:
- Peripheral blood stem cells are collected from contributed blood. The stem cells are separated and collected and the rest of the blood is gone back to the donor.
- Bone marrow stem cells are collected from the donor’s hip bone through a surgery.
- Cable blood stem cells are gathered from the umbilical cable (the part of the placenta that delivers nutrients to a fetus) immediately after a baby is born and the umbilical cord is secured and cut.
While all three types can replenish a patient’s blood and bone marrow cells, there are benefits and drawbacks to each. The doctor will suggest the best type of stem cell for your child’s health problem.
The next step in the transplant procedure is conditioning therapy, which kills unhealthy cells (like cancer cells) to make space for stem cells to grow and/or weakens the body immune system so that there’s less opportunity of the body declining the brand-new cells.
One kind of conditioning therapy delivers high doses of chemotherapy and/or radiation to eliminate cells, ruin the bone marrow, and weaken the immune system. Many kids will get this type of therapy. Another kind of conditioning therapy delivers lower doses of chemotherapy, radiation, or another treatment to damage the body immune system. The doctor will choose which type of conditioning therapy is best.
Soon after the conditioning stage, the transplant itself will be done through intravenous (IV) infusion, and healthy stem cells will be presented to the child’s body. After the infusion, the child will be viewed very carefully to make sure the new stem cells are settling into the marrow and beginning to make new blood cells (called engrafting). Medical professionals will look for any signs of rejection along with graft-verses-host disease in kids with allogeneic transplants.
Engrafting takes approximately 2 weeks, however can be as quick as 1 week or as long as 6 weeks. Your child will get medicines to promote engrafting and avoid rejection and graft-versus-host disease.
Kids who receive stem cell transplants have a high risk of infection. During conditioning therapy and while the transplant is engrafting, their immune systems are weakened and not able to eliminate bacteria and other germs that go into the body. Children who receive an allogeneic transplant have an even greater risk of infection because they need medicines to additional reduce their immune systems to minimize the chance of rejection.
Because of these dangers, a child who’s had a stem cell transplant will not be released from the medical facility up until medical professionals make certain the transplant has actually effectively engrafted and the child is otherwise succeeding.
Once released, a child requires really close tracking and follow-up care. School and other public indoor areas may be off limits for 3 months to a year, and other places may be restricted too. This is because for kids with a jeopardized immune system, even a basic infection like a common cold can be major and even deadly if untreated.
The stress of having a child who is being dealt with for cancer or another major condition can be frustrating for a household. That stress can grow when treatment requires a long “isolation duration,” as is essential with a stem cell transplant.
To learn what support is offered to you and your child, talk with your doctor, a medical facility social employee, or child life professional. Lots of resources are readily available that can assist you get through this hard time.
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